1. FIELD OF THE INVENTION
The present invention relates to methods and apparatus for diagnosis and treatment of psychological and/or emotional conditions in human patients with the aid of a micro-processor-based video game.
2. DESCRIPTION OF THE ART
A patient's behavioral response to his/her medical condition is evaluated and treated in conjunction with other, regular therapy and is conducted by the primary physician or health care specialist. Depending on the medical condition, a preliminary picture of the patient's emotional condition may be available to the specialist in the form of answers to questionnaires or results from a battery of tests.
This type of evaluation is currently necessary in psychological conditions such as schizophrenia, depression, hyperactivity, phobias, panic attacks, anxiety, overeating and other emotional disorders wherein a patient's maladaptive behavioral response to his/her environment is the medical condition to be treated. Currently available tests for classifying such conditions rely on the patient to perform a self-examination and to respond candidly to a series of personal questions. Since most tests differ in their basic scientific assumptions, the results obtained are not'standardized and cannot often be used to make meaningful case comparisons.
When applied to pediatric patients, problems existing in the art are amplified as compliance is not guaranteed and when the answering of questionaires is aided by an adult, the input of the adult usually hampers rather than enhances objective responses. Cohen et al., Am. J. Diseases of Children, 143:1229-33 (1989). Self-evaluating questionnaires that allow a child to assess his or her own situation may provide a valuable comparison between the child's view of his or her behavior and that of adults, but the dependability of these questionnaires, especially in pre-adolescent children, has not yet been determined. Braswell et al., Cognitive Behavioural Therapy with ADHD Children, The Guilford Press, New York (1991). Currently available methods of psychological evaluation are painstaking and tedious, involve long hours of diagnostic evaluation and are, consequently, very expensive.
Following diagnosis, the actual therapeutic changes in the patient usually occur outside of the therapy sessions as cognitive and behavioral strategies learned in therapy are applied by the patient to problems encountered in day-to-day situations. Progress is predicated to a large extent on patient cooperation, discipline and the ability to self-manage. Lack of compliance to long-term therapy regimes present a major obstacle to successful treatment. Children are a particularly difficult group of patients in this respect. Frequently, children lack the understanding, maturity and perseverance required to successfully pursue any kind of a treatment plan.
For most psychological and emotional disorders, the only available criteria for diagnosis and treatment alternatives recognized by the art is compiled in the Diagnostic and Statistical Manual of Mental Disorders, a standard classification text by the American Psychiatric Association. Such criteria are classical categorizations and very academic by nature, and are often impractical for children and uneducated adults.
For instance, Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent childhood psychiatric disorders characterized by behavioral problems, social maladjustment, aggression and academic difficulties, and effects 3 to 5 percent of American children. Erickson, M., Behavior Disorders of Children and Adolescents, Prentice Hall, Englewood Cliffs, N.J. (1987); Barkley, R., Attention Deficit Hyperactivity Disorder, The Guilford Press, New York (1990). ADHD is diagnosed as a debilitating disease of children with negative consequences into adulthood if untreated. However, even with proper and early diagnosis, reliable treatment still does not exist for ADHD.
In the United States, as many as 750,000 children take psychostimulant medication such as methylphenidate, dextroamphetamine or Ritalin.RTM. (CIBA Pharmaceuticals) each day for ADHD. Unfortunately, almost 25 percent of those children experience no behavioral improvement from such drugs, and almost half of the remaining children receive only marginal benefits. Greenhill, L., Psychiatric Clin. of N. America, 14:1-25 (1992). Thus, a need exists in the art for methods and apparatus designed for diagnose of ADHD and sub-categories of ADHD, namely those children who have ADHD but are not responsive to psychostimulants.
Management techniques other than maintenance with psychostimulants exist and involve behavior therapy such as changing the family and school environments. But, these social changes are a daunting task, and a need also exists in the art for methods and apparatus designed for ADHD children using efficient, computer-based education systems which convey assessment data to clinicians to monitor and provide healing support.
There is also a wide variety of maladaptive conditions other than the above-mentioned psychological disorders, requiring extensive self-help and self-treatment. These conditions include compulsive behaviors and addictive, substance abuse. Most common examples are gambling, smoking and alcoholism. At the present time treatment for these medical conditions involves counseling, distraction techniques and chemical replacement therapy. Ultimately, however, all of these methods depend on the cooperation of the patient and a large dose of self-motivation. This is especially important when the patient is in his or her own surroundings where the objects of their addiction or compulsion are easily accessible.
Some attempts have been made at using computers to diagnose and educate patients about their medical condition. Typically these attempts have produced questionnaires which can be filled out on a computer, or educational programs telling the patient more about his or her medical condition. Unfortunately, these projects stop short of being sufficiently adapted to patient needs, and a need exists in the art for a method and apparatus for diagnosis and treatment of psychological and/or emotional conditions in human patients with the aid of a micro-processor-based video game.